Editor's Note: Aligning the Practice Community and Academia

James C. McAllister III, MS, FASHP

Published Online: Sunday, June 1, 2008

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Mr. McAllister is a health-systems consultant based in Chapel Hill, North Carolina.

For years, I have heard practitioners
from virtually all practice
settings complain about schools
of pharmacy failing to prepare professional
students for practice following
graduation. Although I understand their
concerns and recognize that some students
are not prepared to step into the
shoes of an experienced pharmacist
their first day on the job, I also know
that a recent graduate's drug knowledge
is vastly superior to the curriculum provided
to me many years ago. Schools of
pharmacy have a daunting task in terms
of meeting the expectations of diverse
employers regarding a new graduate's
capabilities. A host of factors, such as
growing class sizes, shrinking budgets,
dwindling research funding, competitive
salaries for faculty, and faculty retention,
contribute to the conundrum.

Changes in academia itself may have
an even more profound impact on new
graduate preparedness. The proliferation
of distance learning and Web-based
course work, which does not require
class attendance, minimizes the socialization
and professionalization that historically
occurred during students' college
experience.

I understand that new teaching techniques
are necessary to reduce costs
and expand enrollment using satellite
campuses to meet market demands, but
what may be lost in terms of camaraderie,
a sense of belonging, lifelong friendships,
and professionalization must be maintained.
I am confident that our leading colleges
of pharmacy understand the risks of
what some schools of pharmacy refer to
as an "educational renaissance," but I am
not confident that strategies
are in place to shore up what
may be at risk. Preceptors
must play an important part
in these strategies.

Practitioners in all practice
settings have played an
increasingly important role
in professional education as
schools have migrated to
the entry-level doctor of
pharmacy degree curriculum.
Regrettably, preceptors
and their employers do not
consistently approach their
clerkship responsibilities
with an appreciation for the
importance of the role they
serve in preparing future practitioners.
We must realize that the time consumed
in offering a rich practice experience
is an investment in the profession's
future. All too often relationships between
schools and preceptors (or the
preceptor's employer) are strained with
inconsistent alignment of expectations,
including getting paid for providing the
clerkship itself. Without question, each
school needs a forum and a consistent
process for discussing and permanently
resolving issues.

Aligning practice and academia is a
complex problem, with challenges for
academia, employers, practitioners, and
students. Not only do we need to overcome
historical problems, but we urgently
need to address the consequences
of dramatic changes in teaching methods.
It seems unrealistic to expect that
our professional associations can collectively
lead an initiative with such diverse
challenges. Perhaps the American
Association of Colleges of Pharmacy (with
support from professional associations)
should appoint a commission or other
working group with representation from
all interested parties, including students,
nonpharmacist executives from hospitals
and community pharmacy, academia, and
a diverse corps of practitioners to study
the current state of affairs and make appropriate
recommendations. To ensure
that the group remains on target, minutes
of meetings and preliminary recommendations
should be published frequently as
the process evolves so that ample opportunity
is given for a successful outcome.

Until then, practitioners from all settings
should embrace their colleges of
pharmacy and begin at a local level to
address some of the challenges. I would
suggest that practitioners should (1) participate
in the process of interviewing
applicants for admission, (2) become a
part of early orientation for the students,
(3) volunteer to serve as lecturers or
discussion leaders in class, and (4) lead
a process to substantially enhance the
experiential portion of the curriculum.

I have confidence that we can use our
creativity and professional commitment
to resolve this conundrum, as it is in our
collective best interest. What do you
think?